In the first place, it is important to exclude physiological external pressure, most often caused by the external pressure of the large blood vessels supplying the heart. In addition, because it is adjacent to the thoracic cavity, if there is an occupying lesion in the mediastinum of the thoracic cavity, it may also cause a bulging esophagus. In addition, the most common lesion is the esophagus itself, such as a submucosal bulge of the esophagus with an esophageal polyp. Esophageal polyps are very easy to diagnose endoscopically and can be clearly diagnosed when combined with pathology. However, the most common submucosal bulges in the esophagus, such as adenomas, smooth muscle tumors, and mesenchymal tumors, require further refinement of ultrasound endoscopy to clarify the diagnosis, and the specific treatment varies from person to person. If the diameter is larger than 3 cm, endoscopic resection is required, mainly by EMR and ESD. if it is smaller, less than 3 cm, and does not produce related symptoms, regular review and follow-up is possible.